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术前中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值在可手术的原发性非小细胞肺癌患者中的临床意义

Clinical significance of preoperative neutrophil-lymphocyte vs platelet-lymphocyte ratio in primary operable patients with non-small cell lung cancer.

作者信息

Zhang Hua, Xia Honggang, Zhang Lianmin, Zhang Bin, Yue Dongsheng, Wang Changli

机构信息

Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Center, Huanhuxi Road, Hexi District, Tianjin, China.

Department of Thoracic Surgery, Tianjin Haibin people's Hospital, Tianjin, China.

出版信息

Am J Surg. 2015 Sep;210(3):526-35. doi: 10.1016/j.amjsurg.2015.03.022. Epub 2015 Jun 1.

DOI:10.1016/j.amjsurg.2015.03.022

PMID:26105800

Abstract

BACKGROUND

Our aim was to determinate the prognostic value of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in primary operable patients with non-small cell lung cancer (NSCLC).

METHODS

Six hundred seventy-eight NSCLC patients were enrolled in this study. The prognostic significance of both markers was determined by both univariate and multivariate Cox survival analysis. The cut-off value for NLR and PLR was selected by using receiver operating characteristic curve analysis.

RESULTS

Multivariate analysis showed that NLR was an independent prognostic factor for disease-free survival (hazard ratio = 1.593, 95% confidence interval [CI] 1.277 to 1.988, P < .001) and overall survival (hazard ratio = 1.624, 95% CI 1.304 to 2.022, P < .001). The area under the curve was .640 (95% CI .599 to .682, P < .001) for NLR and .547 (95% CI .503 to .590, P = .036) for PLR, indicating that NLR was superior to PLR as a predictive factor in primary operable NSCLC patients.

CONCLUSIONS

Preoperative NLR represents a significant independent prognostic indicator in primary operable NSCLC patients. Our results also demonstrate that high-risk patients based on the NLR do not benefit from adjuvant chemotherapy.

摘要

背景

我们的目的是确定中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）在可手术切除的原发性非小细胞肺癌（NSCLC）患者中的预后价值。

方法

本研究纳入了678例NSCLC患者。通过单因素和多因素Cox生存分析确定这两种标志物的预后意义。使用受试者工作特征曲线分析选择NLR和PLR的临界值。

结果

多因素分析显示，NLR是无病生存的独立预后因素（风险比=1.593，95%置信区间[CI]1.277至1.988，P<.001）和总生存的独立预后因素（风险比=1.624，95%CI 1.304至2.022，P<.001）。NLR的曲线下面积为0.640（95%CI 0.599至0.682，P<.001），PLR的曲线下面积为0.547（95%CI 0.503至0.590，P=.036），表明在可手术切除的原发性NSCLC患者中，NLR作为预测因素优于PLR。